Thursday, January 20, 2011

Medicinal Leeches: From Nicander of Colophon to the Biting Edge of Medicine

"Biopharm Leeches"
"The Biting Edge of Science"

"Biopharm is the pioneer in medical leech provision and has nurtured the renaissance of leeches in modern surgery. Leeches today are used in plastic and reconstructive surgery worldwide as well as successful ongoing research into relieving symptoms of osteoarthritis...."

Since quite a few folks, and Princeton's WordNet, use "modern" as if it means "contemporary," the Lemming is very mildly irked by that usage. We've been in a postmodern era for decades - and that's another topic. If that doesn't sound very "apathetic," you're quite right. The Lemming's 'apathy' gets explained in "About the Lemming."

Which is another topic.

Let's see - the Lemming was writing about invertebrate bloodsuckers. A variety that doesn't fly.

Biopharm Leeches sells medicinal leeches - which could be used as bait, but are a bit pricey for that sort of thing. The company sells fishing leeches, too. Leeches for fishing, I'm sure: not leeches that fish.

Although as aquatic predators - or parasites - leeches do fish, sort of. Although they're not fish. Wandering a little off-topic again.

There's a pretty good writeup on a particular variety of leech, and leeches in general, at:

Using Leeches in Medicine? How Medieval! How Superstitious!

'Everybody knows' that before Science and Modern Medicine blessed the benighted masses with refrigerated stethoscopes, ignorance and superstition ruled.

Like the idea that leeches might be good for people.
Knives, Needles, and Magic Elixirs: A Rant
The Lemming got the idea that when 'real' doctors nearly drove midwives, herbalists, and other dreadfully old-fashioned and 'unscientific' people out of Western culture, many folks got the idea that healing required knives, needles, and magic elixirs.

We call the latter "prescriptions." Tomayto, tomahto. And the Lemming is not going to start discussing Fred Astair. Not just now, anyway.

Somewhere around the '80s, if memory serves - 1980s, that is - the Lemming noticed a few 'real' doctors using old-fashioned methods, like sensible eating habits and herbal teas, when it made sense.

One licensed physician explained to the Lemming that Western medicine was really good at dealing with an organ system that's gone into failure mode, or setting broken bones. Fine-tuning the human body? Not so much. The doctor didn't use quite those words - but that's the idea.

The Lemming suspects that doctors - in America, at least - were noticing that folks were starting to do their own research: and going to a health food store instead of buying more of the doctor-prescribed magic elixirs. That sort of thing is bad for business.

Do-it-yourself medicine isn't always a good idea, by the way. Some of those 'harmless' herbal concoctions will kill you if the dosage is wrong, or they're taken with something else. It's often harder to overdose on 'natural' medicine than it is with over-the-counter stuff: but it can be done. ("Toxic hepatitis - Causes," "Can herbal supplements interact with my heart disease medications?" (briefly - yes), "Acute liver failure - Causes," on the Mayo Clinic website)
Back to Leeches
It's amazing, how much a person can learn, by accepting the notion that someone else might have a good idea. In the Lemming's opinion.

Like using leeches to balance the body's humors.

The idea that health depended on a proper balance of blood, phlegm, black and yellow bile made sense in Nicander of Colophon's day. As the Lemming recalls, it was part of a larger set of concepts that explained how the universe works.

These days, folks who study the body are equally certain that health depends on a proper balance of hormones and nutrients. Two thousand years from now? We'll see what folks are certain about, then.

Physicians used leeches to balance the humors, not all that long ago. Specifically, they used the bloodsuckers to draw off excess blood.

To someone who grew up in the antiseptic stainless-steel-and-enamel world of modern medicine, that can sound - gross.

And frightfully ignorant.

Not like up-to-date folks who gave us modern miracles like lobotomies. The Lemming's discussed that sort of thing in another blog:Anyway, turns out that sometimes it is a good idea to draw off one of the four humors. Like when blood is collecting in a reattached body part.

Using leeches isn't absolutely safe - but then, neither are those magic elixirs. The Lemming's written about that before:A little background on why leeches stopped being used, and why doctors picked them up agan:

"Medical Use of Medicinal Leeches"
© J.Graf, University of Connecticut (2003)

"During the 1980's, reports were published that described the successful application of medicinal leeches to rescue surgery cases with complications. During the reattachment of severed fingers and ears, or of the detached scalp, the blood flow needs to be reestablished. This is achieved by reconnecting the major arteries and veins. In particular, the veins can be difficult to find. If not enough veins are reconnected, the blood may initially enter the reattached organ but cannot exit. This will prevent fresh, oxygenated blood from entering and, consequentially, the reattachement procedure will fail. This is where the medicinal leech comes to the rescue. The animals are applied to the tissue and they actively remove blood and secrete numerous compounds that have vasodialator, anticoagulant, and clot-dissolving properties. This prevents the tissue from dying off and allows the body to reestablish good blood flow to the reattached part.

"This type of procedure is not without risk. In up to 20% of the patients receiving leech treatment after microvascular surgery, infections by Aeromonas occurred. Fortunately, these infections can usually be prevented by administering antibiotics to the patients. These infections point to the potential of this bacterium, which is cooperative in the medicinal leech, to be pathogenic in humans.

"In patients with a normal immune response and good blood circulations at the site of attachment, bacterial infections do not usually occur.

"Another use of leeches is to reduce the pain of arthritis in the knees. A clinical trial suggested that patients receiving leech thearpy [!]experienced less pain than the control group...."

Before anyone walks away with the idea that leeches are dirty, disease-riddled critters, a reminder: those Aeromonas infections happened because micro-critters that are supposed to be in leeches aren't part of the human roster of microcritters. Healthy human beings have a rather lively little community of intestinal flora (or normal flora, or indigenous microbiota, or whatever). That's why folks sometimes take a while to get their digestion back on track after taking antibiotics.

And the Lemming is not going to get started on that.

Sort-of-related posts:
More about leeches:
  • "Swimming in the Medicinal Leech"
    Andrew Tate, Model Systems in Neuroethology (December 1996)
    • Includes a circuit diagram for part of the leech control system
      • If you're planning to build your own leech?

2 comments:

Brigid said...

There's an extra space in here: "There's a pretty good writeup on a particular variety of leech, and leeches in general, at :"

A missing word: "the Lemming noticed a few 'real' using old-fashioned"

The Friendly Neighborhood Proofreader

P.S. Funny stuff in here. ^_^

Brian, aka Aluwir, aka Norski said...

Brigid,

Found 'em, fixed 'em, thanks!

And thanks for the good words.

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